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World Journal of Gastroenterology 2014年第42期20卷 15925-15930页

作者： Hiroyuki Hachiya Junji Kita Takayuki shiraki Yukihiro Iso Mitsugi Shimoda Keiichi Kubota Second Department of Surgery Dokkyo Medical University

We report a case of intraductal papillary neoplasm of the bile duct(IPNB) that developed in a patient with primary sclerosing cholangitis. A 46-year-old woman was admitted to our hospital with obstructive jaundice. The liver function tests demonstrated increased serum liver enzyme levels. Computed tomography showed dilatation of the intrahepatic bile ducts. Abdominal ultrasonography revealed a highly echoic protruding lesion in the posterior bile duct near the right lobe of the liver. The lesion was suspected to be IPNB, but we were unable to confirm whether it was a carcinoma. A right hepatectomy was performed, and this showed that the dilated bile duct was filled with mucin and contained several yellowish papillary tumors. Histologically, the neoplastic biliary epithelium showed papillary growth in the dilated lumen. The tumor was diagnosed as IPNB, high-grade intraepithelial neoplasia secreting abundant mucin. No recurrence has been detected 3 years after surgery.

关键词： Intraductal papillary neoplasm of the bile duct Primary sclerosing cholangitis Cholangiocarcinoma High-grade intraepithelial neoplasia Premalignant lesion

Intraoperative frozen section diagnosis of bile duct margin for extrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2018年第12期24卷 1332-1342页

作者： Takayuki shiraki Hajime Kuroda Atsuko Takada Yoshimasa Nakazato Keiichi Kubota Yasuo Imai Department of Gastroen- terological Surgery Dokkyo Medical University Department of Diagnostic Pathology Dokkyo Medical University

AIM To evaluate the usefulness of frozen section diagnosis(FSD) of bile duct margins during surgery for extrahepatic cholangiocarcinoma(CCA). METHODS We retrospectively analyzed 74 consecutive patients who underwent surgery for extrahepatic CCA from 2012 to 2017, during which FSD of bile duct margins was performed. They consisted of 40 distant and 34 perihilar CCAs(45 and 55 bile duct margins, respectively). The diagnosis was classified into three categories: negative, borderline(biliary intraepithelial neoplasia-1 and 2, and indefinite for neoplasia), or positive. FSD in the epithelial layer, subepithelial layer, and total layer was compared with corresponding permanent section diagnosis(PSD) ***, association between FSD and local recurrence was analyzed with special reference to *** Analysis of 100 duct margins revealed that concordance rate between FSD and PSD was 68.0% in the total layer, 69.0% in the epithelial layer, and 98.0% in the subepithelial layer. The extent of remaining biliary epithelium was comparable between FSD and PSD, and more than half of the margins lost > 50% of the entire epithelium, suggesting low quality of the samples. In FSD, the rate of negative margins decreased and that of borderline and positive margins increased according to the extent of the remaining epithelium. Diagnostic discordance between FSD and PSD was observed in 31 epithelial layers and two subepithelial layers. Alteration from borderline to negative was the most frequent(20 of the 31 epithelial layers). Patients with positive margin in the total and epithelial layers by FSD demonstrated a significantly worse local recurrence-free survival(RFS) compared with patients with borderline and negative margins, which revealed comparable local RFS. Patients with borderline and negative margins in the epithelial layer by PSD also revealed comparable local RFS. These results suggested that epithelial borderline might be regarded substantially as negati

关键词： Cholangiocarcinoma Bile duct cancer Frozen section diagnosis Permanent section diagnosis Bile duct margin Biliary intraepithelial neoplasia Dysplasia Indefinite for neoplasia Borderline lesion Local recurrence

Primary rhegmatogenous retinal detachment:evaluation of a minimally restricted face-down positioning after pars plana vitrectomy and gas tamponade

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International Journal of Ophthalmology(English edition) 2021年第6期14卷 936-939页

作者： Kiichiro Kusaba Kotaro Tsuboi Tsuneaki Handa Yukihiko shiraki Takuya Kataoka Motohiro Kmaei Department of Ophthalmology Aichi Medical UniversityNagakute-cityAichi 480-1195Japan

AIM:To evaluate the safety and efficacy of a minimally restricted face-down postoperative positioning following pars plana vitrectomy(PPV)with gas tamponade for primary rhegmatogenous retinal detachment(RRD).METHODS:Patients with primary RRD treated with PPV and gas tamponade and followed up for at least 6 mo were selected for the *** phakic eyes underwent simultaneous cataract *** patients were required to be in a postoperative position that prevented downward flow of retinal *** with macular detachment were positioned face-down for only a couple of *** patients were assessed for preoperative and postoperative best-corrected visual acuity(BCVA),anatomical retinal reattachment rate,and postoperative ***:In total,40 eyes of 39 patients with primary RRD were included in the study.A single tear was present in 30 eyes(75.0%),multiple retinal tears were present in nine eyes(22.5%),and oral dialysis was present in one eye(2.5%).The anatomical success rate was 90.0%(36 cases)after the primary surgery,and the final anatomical success rate was 100%.The BCVA improved significantly(P<0.001)from 0.75 logarithm angle of resolution(log MAR)preoperatively to 0.12 log MAR at the final *** complications included intraocular pressure elevation(≥25 mm Hg)in 11 patients(27.5%),fibrin formation in two patients(5.0%),pupillary capture of the intraocular lens in two patients(5.0%),and posterior synechia in one patient(2.5%).CONCLUSION:A minimally restricted face-down and flexible postoperative positioning after PPV and gas tamponade for primary RRD is effective and safe.

关键词： retinal detachment vitrectomy flexible postoperative positioning

Analysis of hepcidin expression: In situ hybridization and quantitative polymerase chain reaction from paraffin sections

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World Journal of Gastroenterology 2012年第28期18卷 3727-3731页

作者： Yuhki Sakuraoka Tokihiko Sawada Takayuki shiraki Kyunghwa Park Yuhichiro Sakurai Naohisa Tomosugi Keiichi Kubota Second Department of Surgery School of Medicine Dokkyo Medical University Kitakobayashi 880 Mibu Shimotsuga Tochigi 321-0293 Japan Proteomics Research Unit Division of Advanced Medicine Medical Research Institute Kanazawa Medical College Daigaku 1-1 Uchinada Kanazawa 920-0293 Japan

AIM: To establish methods for quantitative polymerase chain reaction (PCR) for hepcidin using RNAs isolated from paraffin-embedded sections and in situ hybridization of hepatocellular carcinoma (HCC). METHODS: Total RNA from paraffin-embedded sections was isolated from 68 paraffin-embedded samples of HCC. Samples came from 54 male and 14 female patients with a mean age of 66.8 ± 7.8 years. Quantitative PCR was performed. Immunohistochemistry and in situ hybridization for hepcidin were also performed. RESULTS: Quantitative PCR for hepcidin using RNAs isolated from paraffin-embedded sections of HCC was performed successfully. The expression level of hepcidin mRNA in cancer tissues was significantly higher than that in non-cancer tissues. A method of in situ hybridization for hepcidin was established successfully, and this demonstrated that hepcidin mRNA was expressed in non-cancerous tissue but absent in cancerous tissue. CONCLUSION: We have established novel methods for quantitative PCR for hepcidin using RNAs isolated from paraffin-embedded sections and in situ hybridization of HCC.

关键词： Hepcidin Expression In situ hybridization Immunohistochemistry Real-time polymerase chain reaction

Generation of insulin-producing β-like cells from human iPS cells in a defined and completely xeno-free culture system

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Journal of Molecular Cell Biology 2014年第5期8卷 394-408页

作者： Hussain Md. Shahjalal Nobuaki shiraki Daisuke Sakano Kazuhide Kikawa Soichiro Ogaki Hideo Baba Kazuhiko Kume Shoen Kume Department of Stem Cell Biology Institute of Molecular Embryology and Genetics Kumamoto University Honjo 2-2-1 Chuo-Ku Kumamoto 860-0811 Japan Global-Center of Excellence (6-COE) Kumamoto University Honjo 2-2-1 Chuo-ku Kumamoto 860-0811 Japan Department of Pediatrics Graduate School of Medical Sciences Kumamoto University Honjo 1-1-1 Chuo-Ku Kumamoto 860-8556 Japan Department of Gastroenterological Surgery Graduate School of Medical Sciences Kumamoto University Honjo 1-1-1 Chuo-Ku Kumamoto 860-8556 Japan Department of Neuropharmacology Graduate School of Pharmaceutical Sciences Nagoya City University 3-1 Tanabe Street Mizuho Nagoya 467-8603 Japan Program for Leading Graduate Schools 'HIGO (Health Life Science Interdisciplinary and Glocal Oriented) Program ' Kumamoto University Honjo 2-2-1 Chuo-ku Kumamoto 860-0811 Japan

Human induced pluripotent stem （hiPS） cells are considered a potential source for the generation of insulin-producing pancreatic β-ceUs because of their differentiation capacity. In this study, we have developed a five-step xeno-free culture system to efficiently dif- ferentiate hiPS cells into insulin-producing cells in vitro. We found that a high NOGGIN concentration is crucial for specifically inducing the differentiation first into pancreatic and duodenal homeobox-1 （PDX1）-positive pancreatic progenitors and then into neurogenin 3 （NGN3）-expressing pancreatic endocrine progenitors, while suppressing the differentiation into hepatic or intestinal cells. We also found that a combination of 3-isobutyl-l-methylxanthine （IBMX）, exendin-4, and nicotinamide was important for the differentiation into insulin single-positive cells that expressed various pancreatic β-cell markers. Most notably, the differentiated cells contained en- dogenous C-peptide pools that were released in response to various insulin secretagogues and high levels of glucose. Therefore, our results demonstrate the feasibility of generating hiPS-derived pancreatic β-ceUs under xeno-free conditions and highlight their poten- tial to treat patients with type I diabetes.

关键词： diabetes pancreas ceil therapy hiPS ceils xeno-free differentiation β-cells

Effects of Land Surface Temperature on the Frequency of Convective Precipitation in the Tokyo Area

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Journal of Geographic Information System 2013年第3期5卷 303-313页

作者： Yohei shiraki Yoshinori Shigeta Faculty of Geo-Environmental Science Rissho University Kumagaya Japan

This study uses statistical evaluation by correlation analysis to examine the effects of thermal environment on the frequency of convective precipitation in the Greater Tokyo Area between 12:00 and 18:00 on summer days from 1997 to 2006. To extract the frequency of convective precipitation we used Automated Meteorological Data Acquisition System radar data to obtain detailed rainfall distribution maps, and to extract the urban thermal environment we used surface temperature data from a National Oceanic and Atmospheric Administration weather satellite. Results were a coefficient of determination of 0.01, indicating no clear relation between surface temperature and convective rain frequency in the study area. Examining the convective rain frequency distribution map in conjunction with an elevation map of the area indicates that higher elevation is a better predictor of increased frequency of convective rainfall than is surface temperature. Because this indicates that orographic precipitation has a large influence in the study area, we used an elevation map to exclude hilly and mountainous regions, regions bordering flat areas (under the assumption that wind could easily move orographic precipitation to such areas), and regions containing marine areas. Doing so resulted in a coefficient of determination of 0.38, a clear signal that differences in the thermal environment in the Greater Tokyo Area have an effect on the frequency of convective precipitation. We next focused on metropolitan Tokyo, the most developed part of the region and the part experiencing the most frequent occurrences of convective precipitation, and we performed correlation analysis considering parameters related to buildings. Results indicate that orographic precipitation has a strong influence in metropolitan Tokyo as well, so we excluded those areas that were excluded from the Greater Tokyo Area analysis and again performed correlation analysis. However, we found no clear relation of convective pr

关键词： Remote Sensing Geographic Information System Heat Island Land Surface Temperature Convective Precipitation

New simulation model for bone formation markers in osteoporosis patients treated with once-weekly teriparatide

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Bone Research 2014年第4期2卷 252-258页

作者： Sakae Tanaka Taiji Adachi Tatsuhiko Kuroda Toshitaka Nakamura Masataka shiraki Toshitsugu Sugimoto Yasuhiro Takeuchi Mitsuru Saito John P Bilezikian Department of Orthopaedic Surgery Faculty of MedicineUniversity of TokyoTokyoJapan Department of Biomechanics Institute for Frontier Medical SciencesKyoto UniversityKyotoJapan Medical Affairs Department Asahi Kasei Pharma CorporationTokyoJapan National Center for Global Health and Medicine TokyoJapan Research Institute and Practice for Involutional Diseases NaganoJapan Internal Medicine 1 Shimane University Faculty of MedicineIzumoJapan Toranomon Hospital Endocrine Center TokyoJapan Department of Orthopaedic Surgery Jikei University School of MedicineTokyoJapan Metabolic Bone Diseases Program Division of EndocrinologyDepartment of MedicineCollege of Physicians and SurgeonsColumbia UniversityNew YorkUSA

Daily 20-mg and once-weekly 56.5-mg teriparatide（parathyroid hormone 1–34） treatment regimens increase bone mineral density（BMD） and prevent fractures, but changes in bone turnover markers differ between the two regimens. The aim of the present study was to explain changes in bone turnover markers using once-weekly teriparatide with a simulation model. Temporary increases in bone formation markers and subsequent decreases were observed during once-weekly teriparatide treatment for 72 weeks. These observations support the hypothesis that repeated weekly teriparatide administration stimulates bone remodeling, replacing old bone with new bone and leading to a reduction in the active remodeling surface. A simulation model was developed based on the iterative remodeling cycle that occurs on residual old bone. An increase in bone formation and a subsequent decrease were observed in the preliminary simulation. For each fitted time point, the predicted value was compared to the absolute values of the bone formation and resorption markers and lumbar BMD. The simulation model strongly matched actual changes in bone turnover markers and BMD. This simulation model indicates increased bone formation marker levels in the early stage and a subsequent decrease. It is therefore concluded that remodeling-based bone formation persisted during the entire treatment period with once-weekly teriparatide.

关键词： bone New simulation model for bone formation markers in osteoporosis patients treated with once-weekly teriparatide BMD

Knee Rotation in Relation to Laterality,Sex,Applied Torque,and Knee Angle

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Journal of Sports Science 2018年第3期6卷 209-217页

作者： Seiya Masegi Hitoshi shiraki Shumpei Miyakawa Department of Health and Sports Faculty of Health SciencesNiigata University of Health and WelfareNiigata 950-3198Japan Faculty of Health and Sport Sciences University of TsukubaTsukubaIbaraki 305-8577Japan

Rotational knee laxity is known as an intrinsic risk factor for anterior cruciate ligament ***,there was no convenient way to measure rotational range of *** this end,we developed the RotorMeter,a non-invasive external device intended to measure rotational range of motion of the *** purpose of this study is to use the RotorMeter to clarify the characteristics pertaining to the rotational range of motion of knee in healthy participants under varying conditions.A total of 23 healthy participants participated in the *** of 2.5,5.0,and 7.5 Nm were applied at 90°,60°,and 30°angles of knee flexion to measure the rotational range of motion of knee using the *** participants showed larger rotational range of motion than the males,and no laterality was observed at any flexion angle and applied *** different torques were applied at the same flexion angle,rotational range of motion significantly increased at all flexion angles with increased *** the same torque was applied at different flexion angles,no significant difference in rotational range of motion was observed at any of the flexion angles.

关键词： Knee rotation RotorMeter

A Method for Determining <i>Batillaria attramentaria</i>Distribution Using Aerial Balloon Photography and a Vegetation Index Camera: Demonstration at the Yatsu Tidal Flat, Chiba Prefecture

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Advances in Remote Sensing 2018年第1期7卷 15-24页

作者： Yohei shiraki Toshiyuki Kitazawa Seongwon Lee Yukiko Senga Faculty of Geo-Environmental Science Rissho UniversitySaitamaJapan Faculty of Science Toho UniversityChibaJapan

Located in Chiba Prefecture, the Yatsu Tidal Flat is an important stopover for birds migrating between cold regions such as Siberia and warm regions such as Southeast Asia and Australia. Its importance led to its selection in 1993 as the first tidal flat in Japan to be registered under the Convention on Wetlands of International Importance especially as Waterfowl Habitat (the Ramsar Convention). However, the Yatsu Tidal Flat has in more recent years witnessed blooms of Ulva spp. (sea lettuce) and an increase in exotic species such as Batillaria attramentaria (Japanese mud snail) and Mercenaria mercenaria (hard clam), fueling concerns that the increasing spatial domination of the tidal flat by such species and competition with other species for food may drive a decline in the habitat’s self-cleaning capabilities. For this study, we focused on Batillaria attramentaria, which is now so widely distributed in the Yatsu Tidal Flat as to preclude reliable monitoring via aerial photographs or satellite imagery. Accordingly, we tested the utility of a simplified method for obtaining data on the distribution of Batillaria attramentaria by using aerial balloon photography and a vegetation index camera capable of generating NDVI data. Our results show that under certain conditions, this method can indeed be used to determine Batillaria attramentaria distribution.

关键词： Batillaria attramentaria Ulva spp. NDVI Yatsu Tidal Flat Japan aerial balloon photography

Clinical Results of Arthroscopic Rotator Cuff Repair with a Tape-Attached Anchor

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Open Journal of Orthopedics 2018年第7期8卷 249-256页

作者： Noriaki Shimada Jun’ichi Inoue Katsuhiko shiraki Kazuo Saita Department of Orthopaedic Surgery Saitama Medical Center Saitama Medical University Kawagoe Japan Department of Orthopaedic Surgery Kamifukuoka General Hospital Fujimino Japan

Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic rotator cuff repair with tape-attached anchors would result in better clinical outcomes and reduce the retear rate compared with conventional suture anchors. Methods: We included 83 patients treated by arthroscopic rotator cuff repair with a minimum 1-year follow-up. We divided them into two groups: Use of the HEALICOILRG with ULTRATAPE (group T: 41 shoulders;mean patient age, 64.3 years) and use of the conventional suture anchor (group S: 42 shoulders;mean patient age, 68.9 years). We compared the University of California Los Angeles scores, Japanese Orthopaedic Association scores, range of motion, and retear rate between the two groups. The Student t test and chi-square test were used in statistical analyses. Results: At the 1-year postoperative follow-up, both groups showed improvement in the average University of California Los Angeles score, Japanese Orthopaedic Association score, and range of motion, although no significant difference was found in the retear rate between the two groups. Conclusions: Results of arthroscopic rotator cuff repair with the HEALICOILRG with ULTRATAPE were generally good. However, our results could not demonstrate efficacy of the HEALICOILRG with ULTRATAPE. Further detailed studies are needed to determine its treatment result.

关键词： Arthroscopic Rotator Cuff Repair Transosseous-Equivalent Technique Suture Anchor Tape-Attached Anchor Retear